Activation of the Brainstem but not of the Hypothalamus in Hemicrania Continua without Autonomic Symptoms

Cephalalgia ◽  
2009 ◽  
Vol 29 (9) ◽  
pp. 974-979 ◽  
Author(s):  
P Irimia ◽  
J Arbi ◽  
E Prieto ◽  
R Fernández-Torrón ◽  
E Martínez-Vila
Keyword(s):  
Primary Headache ◽  
Brain Structures ◽  
Complete Response ◽  
Hemicrania Continua ◽  
Single Observation ◽  
Autonomic Symptoms ◽  
Positron Emission ◽  
History Of ◽  
The Brain ◽  
No Activation

A 64-year-old woman presented with a 6-month history of right-sided continuous headache, without autonomic symptoms and complete response to indomethacin. Clinical examination and structural brain imaging were normal. A diagnosis of hemicrania continua (HC) was made. We sought to determine the brain structures active during the pain in a patient who met all of the diagnostic criteria for HC with the exception of autonomic symptoms. A brain positron emission tomography study was performed during pain, and completely pain-free after indomethacin administration. Comparing the pain with pain-free states, the region of the dorsal pons was significantly activated. There was no activation in the hypothalamus, as previously reported in HC with autonomic symptoms. Although definitive conclusions can not be drawn from a single observation, the lack of autonomic symptoms along with the absence of hypothalamic activation suggests that the clinical presentation may predict the pattern of brain activation in primary headache syndromes.

scholarly journals A case of remitting hemicrania continua with seasonal variation and clustering: a diagnostic confusion with cluster headache

2019 ◽  
Vol 12 (5) ◽  
pp. e229650
Author(s):  
Sanjay Prakash ◽  
Kalu Singh Rawat
Keyword(s):  
Discrete Series ◽  
Primary Headache ◽  
Complete Response ◽  
Hemicrania Continua ◽  
Therapeutic Trial ◽  
Cranial Autonomic Symptoms ◽  
Unilateral Headache ◽  
Continuous Background ◽  
Diagnostic Confusion ◽  
History Of

Hemicrania continua (HC) is an indomethacin responsive primary headache that is characterised by a continuous strictly unilateral headache with periodic exacerbations. About 15% may have a remitting subtype of HC. Herein, we are reporting a 36-year-old man who had a 5-year history of episodic right-sided headaches. The headaches used to occur in a discrete series lasting 4–6 weeks, separated by pain-free remissions of 10–11 months. In each relapse, he had continuous background pain with superimposed exacerbations. The superimposed exacerbations were 1–2 attacks per day, lasting for 2–5 hours, and were associated with ipsilateral cranial autonomic symptoms. However, the patient did not respond to usual therapies of custer headache (CH). He had a complete response to indomethacin. We suggest that remitting subtype of HC may mimic CH. A therapeutic trial of indomethacin should be done in all strictly unilateral headaches who are not responding to other drugs.

Hemicrania Continua Evolving from Episodic Paroxysmal Hemicrania

Cephalalgia ◽  
2006 ◽  
Vol 26 (9) ◽  
pp. 1143-1145 ◽  
Author(s):  
F Castellanos-Pinedo ◽  
M Zurdo ◽  
E Martínez-Acebes
Keyword(s):  
Family History ◽  
Migraine Without Aura ◽  
Clinical Course ◽  
Previous History ◽  
Primary Headache ◽  
Complete Response ◽  
Hemicrania Continua ◽  
Paroxysmal Hemicrania ◽  
History Of ◽  
Probable Migraine

A 45-year-old woman, who had been diagnosed in our unit with episodic paroxysmal hemicrania, was seen 2 years later for ipsilateral hemicrania continua in remitting form. Both types of headache had a complete response to indomethacin and did not occur simultaneously. The patient had a previous history of episodic moderate headaches that met criteria for probable migraine without aura and also had a family history of headache. The clinical course in this case suggests a pathogenic relationship between both types of primary headache.

scholarly journals Phenotypic and treatment outcome data on SUNCT and SUNA, including a randomised placebo-controlled trial

Cephalalgia ◽  
2017 ◽  
Vol 38 (9) ◽  
pp. 1554-1563 ◽  
Author(s):  
Hsing-Yu Weng ◽  
Anna S Cohen ◽  
Christoph Schankin ◽  
Peter J Goadsby
Keyword(s):  
Controlled Trial ◽  
Clinical Manifestations ◽  
Primary Headache ◽  
Outcome Data ◽  
Short Term ◽  
Autonomic Symptoms ◽  
Primary Headache Disorders ◽  
Cranial Autonomic Symptoms ◽  
History Of

Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are two rare headache syndromes classified broadly as Trigeminal Autonomic Cephalalgias (TACs). Methods Here, 65 SUNCT (37 males) and 37 SUNA (18 males) patients were studied to describe their clinical manifestations and responses to treatment. Results Pain was almost always unilateral and side-locked. There were three types of attack: Single stabs, stab groups, and a saw-tooth pattern, with some patients experiencing a mixture of two types. As to cranial autonomic symptoms, SUNA patients mainly had lacrimation (41%) and ptosis (40%). Most cases of the two syndromes had attack triggers, and the most common triggers were touching, chewing, or eating for SUNCT, and chewing/eating and touching for SUNA. More than half of each group had a personal or family history of migraine that resulted in more likely photophobia, phonophobia and persistent pain between attacks. For short-term prevention, both syndromes were highly responsive to intravenous lidocaine by infusion; for long-term prevention, lamotrigine and topiramate were effective for SUNCT, and lamotrigine and gabapentin were efficacious in preventing SUNA attacks. A randomized placebo-controlled cross-over trial of topiramate in SUNCT using an N-of-1 design demonstrated it to be an effective treatment in line with clinical experience. Conclusions SUNCT and SUNA are rare primary headache disorders that are distinct and very often tractable to medical therapy.

scholarly journals Hemicrania Continua Associated with Classic Scintillating Scotoma

2018 ◽  
Vol 10 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Eva Auffenberg ◽  
Friedemann Bender ◽  
Tobias Freilinger
Keyword(s):  
Primary Headache ◽  
Headache Disorder ◽  
Complete Response ◽  
Hemicrania Continua ◽  
Response To Treatment ◽  
Visual Aura ◽  
Primary Headache Disorder ◽  
Cranial Autonomic Symptoms ◽  
Potential Link ◽  
Scintillating Scotoma

Hemicrania continua (HC) is a rare primary headache disorder, characterized by persistent unilateral pain associated with cranial autonomic symptoms and prompt response to indomethacin. While migrainous features (including aura) have been recognized in cluster headache, there have been only single reports of HC with aura. Here, we report the case of a 53-year-old man with constant right-sided headache and superimposed exacerbations to severe pain lasting for several hours. Secondary etiologies were excluded, and a diagnosis of HC was established after prompt and complete response to treatment with indomethacin. During an episode of pain exacerbation, for the first time the patient experienced an episode of transient visual disturbances compatible with scintillating scotoma. We propose a potential link between HC and visual aura, which parallels similar observations in other trigeminal autonomic cephalalgias and more specifically confirms previous observational data on aura in HC, thus highlighting potentially shared pathophysiological mechanisms.

scholarly journals Motor Speech Apraxia in a 70-Year-Old Man with Left Dorsolateral Frontal Arachnoid Cyst: A [18F]FDG PET-CT Study

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Nicolaas I. Bohnen ◽  
Jacob Haugen ◽  
Karen Kluin ◽  
Vikas Kotagal
Keyword(s):  
Arachnoid Cyst ◽  
Brain Structures ◽  
Motor Speech ◽  
Left Frontal Lobe ◽  
Neurodegenerative Process ◽  
Positron Emission ◽  
Pet Ct ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Fdg Pet Ct

Motor speech apraxia is a speech disorder of impaired syllable sequencing which, when seen with advancing age, is suggestive of a neurodegenerative process affecting cortical structures in the left frontal lobe. Arachnoid cysts can be associated with neurologic symptoms due to compression of underlying brain structures though indications for surgical intervention are unclear. We present the case of a 70-year-old man who presented with a two-year history of speech changes along with decreased initiation and talkativeness, shorter utterances, and dysnomia. [18F]Fluorodeoxyglucose (FDG) Positron Emission and Computed Tomography (PET-CT) and magnetic resonance imaging (MRI) showed very focal left frontal cortical hypometabolism immediately adjacent to an arachnoid cyst but no specific evidence of a neurodegenerative process.

scholarly journals The Origins of Behavioral Neuroscience from a Learning and Memory Perspective

2019 ◽  
pp. 197-205
Author(s):  
Robert E. Clark
Keyword(s):  
Learning And Memory ◽  
Nobel Prize ◽  
Brain Structures ◽  
Memory Systems ◽  
Behavioral Neuroscience ◽  
History Of ◽  
Memory Perspective ◽  
Modern Era ◽  
The Brain ◽  
Eric Kandel

The discipline of behavioral neuroscience grew out of earlier incarnations such as biological psychology, physiological psychology, and psychobiology. All of these labels essentially refer to the idea that the principles of biology could be productively applied to the study of topics that had been studied before, but only from a more psychological perspective. These topics would include, but are not limited to, motivation, sensation, perception, sleep, emotion, and learning and memory. In this brief review, I focus on the topic of learning and memory and provide a history of the important milestones in the development of ideas about how the brain biologically accomplishes the task of learning and memory. Included are the early ideas of Plato, René Descartes, Théodule Ribot, et al. The review continues to the modern era of learning and memory research that begins with the description of H.M. by Brenda Milner, as well as the gradual discovery that the brain contains multiple learning and memory systems that operate in fundamentally different ways and that are supported by anatomically discrete brain structures. I conclude with a brief description of the work that lead to 2000 Nobel Prize being awarded to Eric Kandel and the 2014 Nobel Prize being awarded to John O’Keefe, Edvard Moser, and May-Britt Moser.

Hemicrania Continua: Who Responds to Indomethacin?

Cephalalgia ◽  
2009 ◽  
Vol 29 (3) ◽  
pp. 300-307 ◽  
Author(s):  
MJ Marmura ◽  
SD Silberstein ◽  
M Gupta
Keyword(s):  
Medication Overuse ◽  
Primary Headache ◽  
Headache Disorder ◽  
Rapid Onset ◽  
Hemicrania Continua ◽  
Paroxysmal Hemicrania ◽  
Autonomic Symptoms ◽  
Primary Headache Disorder ◽  
Unilateral Headache ◽  
Headache Onset

Hemicrania continua (HC) is a primary headache disorder characterized by a continuous, moderate to severe, unilateral headache and defined by its absolute responsiveness to indomethacin. However, some patients with the clinical phenotype of HC do not respond to indomethacin. We reviewed the records of 192 patients with the putative diagnosis of HC and divided them into groups based on their headaches' response to indomethacin. They were compared for age, gender, presence or absence of specific autonomic symptoms, medication overuse, rapidity of headache onset, and whether or not the headaches met criteria for migraine when severe. Forty-three patients had an absolute response and 122 patients did not respond to adequate doses of indomethacin. The two groups did not differ significantly in terms of age, sex, presence of rapid-onset headache, or medication overuse. Autonomic symptoms, based on a questionnaire, did not predict response. Eighteen patients could not complete a trial of indomethacin due to adverse events. Nine patients could not be included in the HC group despite improvement with indomethacin: one patient probably had primary cough headache, another paroxysmal hemicrania; three patients improved but it was uncertain if they were absolutely pain free, and four patients dramatically improved but still had a baseline headache. We found no statistically significant differences between patients who did and did not respond to indomethacin. All patients with continuous, unilateral headache should receive an adequate trial of indomethacin. Most patients with unilateral headache suggestive of HC did not respond to indomethacin.

scholarly journals Brain activity during moral judgement of action

2020 ◽  
Vol 9 (2) ◽  
pp. 67-81
Author(s):  
K.R. Arutyunova ◽  
I.M. Sozinova ◽  
Yu.I. Alexandrov
Keyword(s):  
Brain Activity ◽  
Age Groups ◽  
Brain Structures ◽  
Interdisciplinary Studies ◽  
Moral Judgement ◽  
Individual Development ◽  
Functional Systems ◽  
History Of ◽  
Neurophysiological Mechanisms ◽  
The Brain

Interdisciplinary studies of cognitive and neurophysiological mechanisms of moral judgement often combine tools borrowed from philosophy, psychology and neuroscience. In this work, we review the studies of brain activity during moral judgement at different stages of individual development. Generally, it has been shown that moral judgement is accompanied by activations in brain areas related to emotion and social cognition; and these activations may vary across individuals of different age groups. We discuss these data from the positions of the system-evolutionary theory and compare our view with the domain-general approach to cognitive processes and brain activity underlying moral judgement. We suggest that moral judgement, as part of individual behaviour, is supported by activity of functional systems formed at different stages of individual development; therefore brain activity during moral judgement is accounted for by the specificity of distribution of neural elements of functional systems across the brain structures, which is determined by the history of an individual’s interactions with the environment.

Familial hemicrania continua

Cephalalgia ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 245-249 ◽  
Author(s):  
Mark W Weatherall ◽  
Anish Bahra
Keyword(s):  
Cluster Headache ◽  
Migraine With Aura ◽  
Genetic Predisposition ◽  
Primary Headache ◽  
Familial Hemiplegic Migraine ◽  
Hemicrania Continua ◽  
Hemiplegic Migraine ◽  
Mother And Daughter ◽  
The Brain

There are now three known causative genes for familial hemiplegic migraine and increasing evidence to support a genetic predisposition to the more common types of migraine with and without aura, and for cluster headache. We present the first reported case of familial hemicrania continua. A mother and daughter developed hemicrania continua at the same time of life. Both showed an absolute response to indometacin and at similar doses. Both also suffered from migraine with aura. We discuss the increasing support for a genetic predisposition to dysfunction of the pain system within the brain manifesting as primary headache.

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